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Emphysematous Pyelonephritis (EPN) is a rare, gas-forming infection of the renal parenchyma associated with significant morbidity and mortality. We report the case of a 39 year-old woman with uncontrolled diabetes who presented with abdominal pain, fevers and chills for one month. Physical exam was notable for dry oral mucosa and left costovertebral angle tenderness. Labs showed acute kidney injury and a hyperglycemic hyperosmotic state. CT abdomen revealed emphysematous pyelonephritis with a large left renal abscess. EPN should be considered in diabetic patients, especially those with uncontrolled or new-onset diabetes and those presenting with symptoms of urinary tract obstruction. Prognostic factors include thrombocytopenia, shock, altered mental status and need for hemodialysis. Our patient was treated successfully with intravenous antibiotics, percutaneous drainage, strict glucose control and monitored with serial imaging. She underwent laparoscopic nephrectomy one month later. Early diagnosis of EPN is essential as it carries a high mortality and a strong clinical suspicion is required, as patients may have an atypical presentation.

Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. About 200 cases have been reported in the English literature until now. Pathomorphologically, these tumors showed great similarities to ductal carcinoma of the female breast, which is why they described this tumor as "salivary duct carcinoma." The authors describe a new case of salivary duct carcinoma of the parotid gland. We present the case of a 43-year-old patient with swelling over Left Parotid Region with no history of Facial Nerve Palsy. The MRI examination of the head showed a large irregular marginated solid soft tissue of left parotid gland, with infiltration of adjacent soft tissue with bony erosion. A Pre-Operative FNAC showed findings suggestive of a Salivary Gland Neoplasm. A malignant tumor was strongly suspected, so that a total left parotidectomy with excision of the adjacent facial nerve and left lymph node dissection was performed. Microscopic examination concluded to a salivary duct carcinoma of the left parotid gland negative with Her2/neu antibody with lymph node metastasis. Salivary duct carcinoma of the parotid gland is a rare tumor with an aggressive behavior. This is due to its propensity to infiltrate distant organs. The diagnosis is based on microscopic examination. Treatment modalities are non-consensual, but some authors advocate the necessity of aggressive approach, especially in tumors negative with Her2/neu antibody. This is due to the fact that the overexpression of this antigen was reported to be associated with a poor prognosis.